Sensitivity of the Unruptured Intracranial Aneurysm Treatment Score (UIATS) to detect aneurysms at high-risk of rupture: Retrospective analysis in a cohort of 346 patients with a proven subarachnoid hemorrhage

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2024-09-10 DOI:10.1016/j.neuchi.2024.101591

Benjamin Buhot , Yann Seznec , Marie-Charlotte Tetard , David Charier , Jérome Morel , Marina Sachet , François Vassal

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引用次数: 0

Abstract

Introduction

The aim of this study was to assess the capability of the Unruptured Intracranial Aneurysm Treatment Score (UIATS) to discriminate unruptured intracranial aneurysms (UIAs) at high risk for subarachnoid hemorrhage (aSAH).

Material and method

During the period from January 2012 to December 2022, we included all consecutive adult patients admitted to our institution for an aSAH caused by the rupture of a saccular IA. The patient-related, aneurysm-related and treatment-related risk factors considered by UIATS were retrieved from medical records. After UIATS calculation for all ruptured IAs in the cohort, patients were categorized as “true positives (TP)” if UIATS would have (appropriately) oriented the management toward treatment, whereas patients for whom the UIATS would have (inappropriately) recommended observation were categorized as “false negatives (FN)”. Patients for whom UIATS was inconclusive were categorized as “undetermined (UND)”. Sensitivity of the UIATS (Se _UIATS) was calculated by using the following formula: TP/(TP + FN).

Results

A total of 346 patients (253 women, 73%; mean age = 56 ± 1.45 years) were incorporated into the final analysis. There were 140 T P (40%), 79 F N (23%) and 127 UND (37%), leading to a Se _UIATS of 63.9% (CI 58.3–69.5). Cumulatively, the UIATS failed to provide an appropriate recommendation in 60% of the entire cohort.

Conclusion

By retrospectively applying the UIATS in a cohort of ruptured IAs, our study emphasizes how vulnerable the UIATS can be. Even if the UIATS suggests conservative management, clinicians should inform patients that there is still a small risk of rupture.

查看原文本刊更多论文

未破裂颅内动脉瘤治疗评分（UIATS）检测高破裂风险动脉瘤的灵敏度：对 346 名确诊蛛网膜下腔出血患者进行的回顾性分析

引言本研究旨在评估未破裂颅内动脉瘤治疗评分（UIATS）对蛛网膜下腔出血（aSAH）高风险未破裂颅内动脉瘤（UIAs）的判别能力。UIATS 考虑的患者相关、动脉瘤相关和治疗相关风险因素均来自医疗记录。对队列中所有破裂的椎管内动脉瘤进行 UIATS 计算后，如果 UIATS 会（适当地）将管理导向治疗，则将患者归类为 "真阳性（TP）"，而如果 UIATS 会（不适当地）建议观察，则将患者归类为 "假阴性（FN）"。UIATS 无法得出结论的患者被归类为 "未确定 (UND)"。UIATS 的灵敏度（Se UIATS）按以下公式计算：结果共有 346 名患者（253 名女性，占 73%；平均年龄 = 56 ± 1.45 岁）被纳入最终分析。其中 T P 140 例（占 40%），F N 79 例（占 23%），UND 127 例（占 37%），UIATS Se 为 63.9% (CI 58.3-69.5)。我们的研究通过在一组破裂的 IA 中回顾性应用 UIATS，强调了 UIATS 的脆弱性。即使 UIATS 建议采取保守治疗，临床医生也应告知患者仍有很小的破裂风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.